Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 5561 | KS |
NPI | 1003097130 |
---|---|
Provider Name | Julie N Jones |
First Address | El Dorado, KS 67042-1469 |
Second Address | El Dorado, KS 67042-1469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2007 |
Last Update Date | 16/11/2007 |